Atila EROĞLU, Fatma GENÇ, Yusuf BİLEN, Yener AYDIN, İbrahim KAPLAN, Mevlüt Sait KELEŞ

The evaluation of plasma arginine, arginase, and nitric oxide levels in patients with esophageal cancer

Amaç: Çeşitli kanserlerde plazma arginin, arginaz ve nitrik oksit (NO) ile ilgili birçok çalışma yapılmış ve bu parametrelerin kanser hastaları için belirleyici faktörler olabileceği ileri sürülmüştür. Bu çalışmada özofagus kanserli hastalarda plazma arjinin, arjinaz ve nitrik oksit seviyeleri değerlendirildi. Yöntem ve gereç: Çalışmaya özofagus kanseri tanısı konup henüz opere edilmemiş 51i kadın ve 49u erkek olmak üzere 100 hasta dahil edildi. Olguların yaş ortalamaları 62,03 ± 12,4 idi. Radyoterapi veya kemoterapi alan hastalar çalışmaya dahil edilmedi. Yaş ortalamaları 57 ± 12,4 olan 38 kadın ve 42 erkek olmak üzere 80 bireyden oluşan kontrol grubu oluşturuldu. Olguların plazma arginin ve NO düzeyi ile arginaz aktivitesi ölçüldü. Arginin düzeyi yüksek performanslı likit kromatografi yöntemi, nitrik oksit düzeyi Griess reaksiyonuyla, arginaz aktivitesi ise modifiye Geyer ve Dabich metoduyla ölçüldü. Bulgular: Plazma arginin konsantrasyonu özofagus kanserli hastalarda kontrol grubuna oranla belirgin derecede düşük, nitrik oksit düzeyi ve arginaz aktivitesi ise kontrol grubuna oranla önemli derecede yüksek bulundu (sırasıyla P < 0,0001, P < 0,0001 ve P = 0,005). Arginaz ve nitrik oksitin sensitivitesi % 87 ve % 89, spesifitesi ise % 65 ve % 66 olarak hesaplandı. Arginin, nitrik oksit düzeyleri ve arginaz aktivitesi, uzak organ metastazı olan hastalar ile metastaz olmayan hastalarla kıyaslandığında istatistiksel olarak anlamlı bir fark bulunmadı (P > 0,05). Benzer şekilde bu parametreler yassı epitel hücreli karsinom ve adenokarsinomalı hastalar ile kıyaslandığında da istatiksel olarak anlamlı bir fark saptanmadı (P > 0,05). Sonuç: Elde ettiğimiz sonuçlar özofagus kanserli hastaların tanısında plazma NO düzeyi ile arginaz aktivitesinin bir tümör belirteci olarak kullanılabileceğini göstermektedir. Ancak bununla ilgili daha kapsamlı ve ileri düzeyde çalışmalara ihtiyaç vardır.

Özofagus kanserli olgularda plazma arginin, arginaz ve nitrik oksit seviyelerinin değerlendirilmesi

Aim: Many studies have been conducted to investigate plasma arginine, arginase, and nitric oxide (NO) levels in patients with different types of cancer, and it has been suggested that these might be important factors for patients with cancer. In the present study, plasma arginine, arginase, and nitric oxide levels were evaluated in patients with esophageal cancer. Materials and methods: A total of 100 patients (51 females and 49 males) diagnosed with esophageal cancer but not yet operated on were included in the study. The mean age of the study population was 62.03 ± 12.4 years. Patients treated with radiotherapy or chemotherapy were excluded. The control group included 80 subjects (38 females and 42 males) with a mean age of 57 ± 12.4 years. Plasma arginine, NO levels, and arginase activity were measured. High-performance liquid chromatography, Griess reactions, and modified Geyer and Dabich methods were used to detect the arginine levels, NO levels, and arginase activity. Results: In patients with esophageal cancer, plasma arginine concentrations were significantly lower and NO levels and arginase activity were significantly higher than in the control groups (P < 0.0001, P < 0.0001, and P = 0.005, respectively). The sensitivity of arginase and NO were estimated at 87% and 89%, with respective specificities of 65% and 66%. Between the patients with and without distant organ metastasis, there were no significant differences in arginine/ NO levels and arginase activity (P > 0.05). Similarly, there were no signifi cant differences in these parameters between the patients with squamous cell carcinoma and adenocarcinoma (P > 0.05). Conclusion: The results demonstrate that plasma NO levels and arginase activity may be used as markers for the diagnosis of esophageal cancer. However, larger and more comprehensive studies are needed.

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